PDF(Pubmed)
Abstract：
BACKGROUND: First- and second-generation anti-epithelial growth factor receptor tyrosine kinase inhibitors have shown great efficacy in the treatment of advanced adenocarcinoma with epithelial growth factor receptor mutations, but this efficacy is limited by certain resistance mechanisms, in particular the T790M mutation, which must be screened before second-line treatment with osimertinib is indicated. The search for this mutation is sometimes difficult, especially in cases of intracranial relapse, through this case report we attempt to discuss the possibility of initiating treatment with osimertinib despite an unknown T790M mutation in such situation.
METHODS: We present the case of a 70-year-old Moroccan male patient diagnosed with non-small cell lung carcinoma initially metastatic to the pleura with an epithelial growth factor receptor mutation who received gefitinib in first line with a complete response, he subsequently presented with cerebral oligo-progression with extra cranial stability. The patient was started on osimertinib with unknown T790M status, as it was impossible to perform a cerebral biopsy, the evolution was characterized by a partial response followed by stereotactic radiotherapy then a complete response for 2 years.
CONCLUSIONS: We can discuss osimertinib as an option for patients with stage IV non-small cell lung cancer with brain oligo-progression on prior tyrosine kinase inhibitors and unknown T790M status, further studies are needed in this area.
METHODS: We present the case of a 70-year-old Moroccan male patient diagnosed with non-small cell lung carcinoma initially metastatic to the pleura with an epithelial growth factor receptor mutation who received gefitinib in first line with a complete response, he subsequently presented with cerebral oligo-progression with extra cranial stability. The patient was started on osimertinib with unknown T790M status, as it was impossible to perform a cerebral biopsy, the evolution was characterized by a partial response followed by stereotactic radiotherapy then a complete response for 2 years.
CONCLUSIONS: We can discuss osimertinib as an option for patients with stage IV non-small cell lung cancer with brain oligo-progression on prior tyrosine kinase inhibitors and unknown T790M status, further studies are needed in this area.
摘要：
背景：第一代和第二代抗上皮生长因子受体酪氨酸激酶抑制剂在治疗上皮生长因子受体突变的晚期腺癌中显示出巨大的疗效，但是这种功效受到某些抗性机制的限制，特别是T790M突变,在接受奥希替尼二线治疗之前，必须对其进行筛查。寻找这种突变有时很困难，尤其是在颅内复发的病例中，通过本病例报告,我们试图讨论开始使用奥希替尼治疗的可能性,尽管在这种情况下T790M突变未知.
方法：我们介绍了一名70岁的摩洛哥男性患者，该患者被诊断为非小细胞肺癌，最初转移到胸膜并伴有上皮生长因子受体突变，在一线接受吉非替尼治疗，完全缓解，随后，他出现了脑低聚进展，颅外稳定。患者开始服用奥希替尼，T790M状态未知，因为不可能进行脑活检,演变的特征是部分反应，然后是立体定向放射治疗，然后是2年的完全反应。
结论：我们可以讨论奥希替尼作为IV期非小细胞肺癌患者的一种选择，这些患者在接受过酪氨酸激酶抑制剂且T790M状态未知的情况下脑寡进展，这方面还需要进一步的研究。
方法：我们介绍了一名70岁的摩洛哥男性患者，该患者被诊断为非小细胞肺癌，最初转移到胸膜并伴有上皮生长因子受体突变，在一线接受吉非替尼治疗，完全缓解，随后，他出现了脑低聚进展，颅外稳定。患者开始服用奥希替尼，T790M状态未知，因为不可能进行脑活检,演变的特征是部分反应，然后是立体定向放射治疗，然后是2年的完全反应。
结论：我们可以讨论奥希替尼作为IV期非小细胞肺癌患者的一种选择，这些患者在接受过酪氨酸激酶抑制剂且T790M状态未知的情况下脑寡进展，这方面还需要进一步的研究。
